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Birthrates Help Keep Filipinos in Poverty

Strong Public Support for Contraception

Maria Susana Espinoza of Manila did not know how birth control worked until after her fourth child was born. Soaring rice prices have focused attention on population growth.
Maria Susana Espinoza of Manila did not know how birth control worked until after her fourth child was born. Soaring rice prices have focused attention on population growth. (Blaine Harden - Blaine Harden -- The Washington Post)

There appears to be widespread public support in the Philippines for modern contraceptives.

Public opinion surveys in recent years have consistently found that about 90 percent of respondents supported government funding of contraceptives for people who cannot afford them.

Surveys by the government also show that poor families have significantly more unwanted pregnancies than richer families -- and much more difficulty finding affordable contraceptives.

The problems the poor face in finding contraception products will increase sharply this year as the Philippine government and USAID end the distribution of donated contraceptives, according to Suneeta Mukherjee, country representative for the U.N. Population Fund. "The poor cannot afford to go somewhere and buy contraceptives," she said. "Many cannot even afford the transportation. By the time they go, they are already pregnant."

The government's plan for "contraceptive self-reliance" anticipates that market forces will make condoms and other products available in shops or that they will be given to the poor by local governments.

But Mukherjee predicted that these new sources will not keep up with demand. "Access to contraceptives will be restricted for most of those who cannot pay and for many who might be willing to pay," she wrote in a February report.

A reduction in the use of contraception -- which is now about 33 percent among women of childbearing age -- will lead to an increase in abortions, Mukherjee predicts.

Abortion is illegal here, but a 2006 study found that there were about 473,000 a year, which accounts for about a third of women with unwanted pregnancies. The study also found that 80 percent of abortions had complications requiring medical treatment.

As for the efficacy of "natural" methods to control population growth, Mukherjee said "it does not work."

At the U.S. Embassy in Manila, an official confirmed that USAID would soon end all donations of contraceptives, after having phased out the program over several years.

But this does not mean less U.S. money for family planning. The official said that USAID has increased its budget, from about $12 million to about $15 million a year, to provide technical assistance to 700 local governments and "to help the private sector to grow the market" for contraceptives.

"We are working in a devolved setting," said the official, who spoke on condition of anonymity. "I am not saying it is a perfect situation."

'I Don't Want Any More Children'

In the garbage dump on Manila Bay, Espinoza said she is nervous about getting an IUD. But she sees no alternative. "I already have so many kids I have trouble looking after them," she said.

Until her fourth child was born in October, Espinoza, 26, had time to work as a scavenger in the dump, collecting plastic bottles. On a good 10-hour day, she said, she could collect enough bottles to earn $1. Her husband sells salt and sometimes makes $4 a day.

Espinoza is the oldest of nine children and left school after fifth grade. She grew up in another Manila garbage dump, where her parents also worked as scavengers.

"I don't want any more children," she said. "Life is hard. Rice is expensive."


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